Today on the Gut Health Reset Podcast, we are discussing “visceral manipulation” with Dr. Amy Osborne! Your abdominal organs, also known as your viscera, are packed very tightly inside your abdominal cavity. But to function properly, they need to be able to move and slide around each other, and if they are physically damaged or impaired, you might find yourself suffering through serious discomfort and pain. In order to solve these issues and restore proper function and balance to your gut, you may want to consider the therapeutic techniques known as visceral manipulation.
In this episode, we will answer these questions:
– What is visceral manipulation?
– Is there a difference between visceral manipulation and visceral mobilization?
– How does endometriosis affect the gut?
– What issues can affect the movement of our abdominal organs/viscera?
– Who can benefit from visceral mobilization techniques?
– And more!
Still want to learn more? Schedule with Dr. Barter today!
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About Dr. Amy Osborne:
Amanda (“Amy”) has a Bachelor of Science in Neuroscience and received her Doctorate in Physical Therapy from Northwestern University in Chicago. Having spent her entire professional career in pelvic health, she has undergone extensive training in many pelvic floor rehabilitation methods. She is also the recipient of the Certificate of Achievement in Pregnancy & Postpartum Physical Therapy from the APTA. She is very passionate about the promotion of pelvic health and breast cancer survivorship and often guest lectures for professional organizations and other community organizations.
Amy is also very involved in the fitness community, as a ACE-certified personal trainer and fitness instructor. She teaches courses for correction of diastasis recti, has extensive experience with exercise prescription for the prenatal and postpartum populations and works with local gyms to educate the community about pelvic floor dysfunction and pain management.
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Dr. Ann-Marie Barter is a Functional Medicine and Chiropractic Doctor at Alternative Family Medicine & Chiropractic. She is the clinic founder of Alternative Family Medicine & Chiropractic that has two offices: one in Longmont and one in Denver. They treat an array of health conditions overlooked or under-treated by conventional medicine, called the “grey zone”. https://altfammed.com/
*As always, this podcast is not designed to diagnose, treat, prevent or cure any condition and is for information purposes only. Please consult with your healthcare professional before making any changes to your current lifestyle.*
Dr. Amy Osborne: You think about the abdominal cavity, all of those organs are really packed in there pretty tightly, right? Everything has its place. They need to be able to slide on top of one another because there’s really not a lot of space within that that cavity. So we want to make sure that there’s adequate movement of the organs. They can slide the directions that they need to so that they can function correctly.
Disclaimer: The information provided in this podcast is educational and not intended to diagnose or treat medical conditions.
Intro: Are you struggling with bloating, gas, constipation and fatigue but don’t know what’s causing these problems? The Gut Health Reset Podcast with Dr. Ann-Marie Barter dove deep into the root causes behind these issues that start in the gut. This podcast will give you the knowledge you need to heal your gut and reset your health.
Dr. Ann-Marie Barter: Dr. Amy, thank you so much for coming on the podcast today. It’s such a pleasure to have you on and I’m super excited to talk about the technique that you do. One of the techniques that you do in your clinic and that technique is visceral manipulation. And so first for starters, can you tell the audience what visceral manipulation is?
Dr. Amy Osborne: Yeah, of course. Visceral manipulation is also known as visceral mobilization. So if you hear that they’re synonymous, it’s a technique whereby we really address how the organs are moving out of all of the modalities that I’ve ever used, it’s probably the gentlest so. I’d take a step back when we think about what? What what do you mean by gut mobility? You think about the abdominal cavity. All of those organs are really packed in there pretty tightly, right? Everything has its place and they need to be able to slide on top of one another because there’s really not a lot of space within that that cavity. So we want to make sure that there’s adequate movement of the organs. They can slide the directions that they need to so that they can function correctly. Now, organs also are smooth muscle, right? So they’re under that autumn autonomic nervous control, meaning they kind of got their own inherent rhythm and we refer to that as motility. So think about mobility is how does the organ, one organ move in relation to the other and motility as how does the organ move inside itself? Right. That makes a lot of sense that every like for example, the large intestine has a lot of it needs to have a lot of motility to move the food along and finally excrete it. Right. So visceral manipulation is just making sure that we have appropriate mobility and motility of all of our organs.
Dr. Ann-Marie Barter: So why is this really important for the gut specifically?
Dr. Amy Osborne: Mm hmm. Because if you think about with respect to motility, there can be a lot of things that lead to loss of motility. And we hear a lot about this. Right. Clinically, I think a lot of people either hear about or experience, gosh, it feels like I eat something and it sits like a rock in my stomach or constipation is a huge one. Right. Or we can also see the other side of the coin where things are being excreted way too quickly. Like I eat something and my food is coming out and it’s not fully digested or what have you not fully absorbed. So it’s really important to make sure that our organs are moving at the appropriate pace so that they can perform the functions that they need to perform. When we think about it from a mobility standpoint, if we’ve got somebody that. Let’s say, has some scar tissue, whether that’s from trauma or endometriosis or some sort of adhesions, and that one particular organ can’t move in terms in risk with respect to the other organs, then we’re going to see potentially pain or even dysfunction of other organ systems. So for example, if you think about the duodenum, for example, if there is physical adhesion in that area, it’s going to affect its ability to actually maintain its motility. And if it can’t move with respect to other things, gosh, think about how much else sits on top of that. We could be seeing issues in the root of the mesenteric, which could maybe be causing back pain. Those sorts of things.
Dr. Ann-Marie Barter: I’m going to back you up a little bit because you use a lot of clinical terms. So when you say the duodenum, you mean the small intestine. Correct. And then you’re saying in relation to, for example, endometriosis type. How so? I know this is going to be simple for you, but how does endometriosis affects the gut or how does that pathophysiology really impact the gut?
Dr. Amy Osborne: Sure. So endometriosis right. Is where cells that are really similar to the endometrium, they’re not exactly the same as the endometrium, which is the lining of the uterus can grow outside of the uterus. And just like the endometrium they’ll build up as time goes on and the endometrium inside the uterus will shed every month under normal circumstances. But there’s really not a means by which for that tissue to exit the body when it grows on the small intestine or really anywhere within that abdominal cavity. And so it ends up forming something very I mean, comparable to scar tissue, really. It’s like an adhesion.
Dr. Ann-Marie Barter: Absolutely. And that definitely mimics that problems all day long.
Dr. Amy Osborne: Mhm. For you, I mean clinically we see so much of people with endometriosis or maybe they haven’t even been diagnosed with endometriosis, been experiencing a fair amount of gastric symptoms, whether it’s IBS type symptoms or gastroparesis where their stomach isn’t emptying. We see a lot of that.
Dr. Ann-Marie Barter: Well, you mentioned something interesting and I get this clinically a lot, so I want to just clear this up. Trauma. Okay. So trauma being and most people associate trauma with a major impact. I was not I don’t I don’t think I have any trauma. I don’t I haven’t been in a car accident. I haven’t been hit really hard in my abdomen, etc.. Can you go into different things that can create scar tissue in the in the gut abdominal region?
Dr. Amy Osborne: Sure. Sure. Well, I’ll start with that. Really, the most basic thing that you’ve already touched on is like blunt force trauma, of course, that that could be getting hit. And when playing a contact sport. Big one that we see a seatbelt in a car accident. Right. That’s a pretty big blunt force to the abdomen and something that a lot of people don’t consider is surgery, which of course, is also trauma to the abdomen. Right. Because scar tissue, if anybody listening has ever done any sort of cadaver work, I think the thing that we were really always surprised by as students was how much fascia there was and how restricted it could get. You know, you might see this really big bundle of fascia in somebody’s stack, but they didn’t have any sort of external indications that they had had any any incision. But there was something in the front. So certainly with that sort of thing, we can see proliferation of scar tissue with any sort of abdominal surgery, even if it is laparoscopic. Right, because there were still invading that space and there can be the body can respond and need to heal it and respond by creating a little bit more fashion. So I always remind people that any history, any history of surgical, any abdominal surgery excuse me, could be a contributor. Same thing goes to right for any sort of surgical intervention in the back. Right. Because that scar tissue can also wrap around to the front as well, perhaps in the hip pelvis, that sort of thing. What are a little bit less obvious signs or things that can create trauma would be pregnancy simply by having that really big expansion of the uterus. That can be enough right to to trigger some some response in the body, whether that is scar tissue or adhesions or simply lack of mobility. Other less obvious causes would be potentially like a really bad infection or simply having had to be on antibiotics. Right. And having something that maybe really, really affected your bowels, that can be trauma to the gut. And then I think the least obvious is anything that affects our autonomic nervous system. Right? So when we think about that autonomic nervous system and your listeners may know this, but thinking of it as fight or flight or rest and digest, there’s no middle ground between those where either in one or the other. Right. And if we are not in rest or digest, we’re in fight or flight. And unfortunately, many of us spend a lot of our time in that fight or flight place. And when we aren’t spending most of our time in rest and digest, we lose what we call the vagal tone to the vagus nerve is what innervate all of those organs of the gut, keep them moving really rhythmically and with a lot of control. And when we have a loss of vagal tone, that is a huge source of trauma for people. So whether that is something like mental emotional trauma or simply by living a really stressed out life, not getting enough sleep, things simple as that can be trauma to the gut.
Dr. Ann-Marie Barter: Great, great. An explanation of that. So we’ve talked about a couple ways we can tell in the gut if we’ve had adhesions, you know, primarily, you know, diarrhea, constipation, gastroparesis, etc.. What are other symptoms that maybe we have some facial adhesions and visceral manipulation?
Dr. Amy Osborne: Sure. So in addition to the ones that you’ve already mentioned, really anything going on with. Gastric issues. So perhaps it’s that you’re having a hard time actually secreting bile. We can get sluggish bile duct because of the actual motility of the gallbladder. So that’s a huge sign. Certainly pain after you eat can be a huge sign. Even gas and bloating can be indications that there could be some restriction. And of course, it’s multifactorial. Right? So maybe somebody’s got a little bit of dysbiosis or maybe somebody has some increased intestinal permeability or leaky gut and they do everything in their power to heal that. But things persist. That’s kind of a sign that maybe we actually if those symptoms have been going on long enough, have some adhesions in the gut. Other signs that are really surprising can be urinary frequency, feeling like you’ve got to go pee all the time, maybe incomplete emptying of the bladder because that bladder isn’t moving the way that it should. Similarly, an inability to fully empty the rectum or feeling like you’ve got to go to the bathroom all the time. Incomplete, emptying. When it comes to stool, that can also be a sign. And then maybe some less obvious signs would be hip pain, low back pain, because those adhesion could be pulling on musculoskeletal structures and affecting the way that that the whole lumbar spine and pelvic girdle and even have girdle move.
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Dr. Amy Osborne: I find something typically all the time. Now, obviously, the people that are walking through the door of my clinic. Right. Are coming in because they’ve got some sort of symptom that they want to deal with. So maybe I’m just biased in thinking that everybody has a little bit of something. But I would say most people do. I don’t think I’ve ever worked on anybody where I haven’t felt at least a little bit of something going on because we all, I think simply by being humans and living a human existence in this stressful world might have a little bit. So I think that everybody could benefit from it for certain.
Dr. Ann-Marie Barter: And do you mind telling your story about when you started visceral manipulation and kind of how you felt around that and then what an impact it really made?
Dr. Amy Osborne: Mm hmm. Yeah. This is maybe a little bit of a long story, but I had heard such wonderful things about it. It was probably 2017 that I first got into it and I went down to this course and it was in Sedona, which is a really special place. And at that point in my career, I think that I was having the inclination that I was missing the boat. I had done a lot of training and functional nutrition to really try to expand my practice, but it was like, Gosh, there’s something missing. I’m doing a lot of mechanical things with people’s spinal alignment and their pelvic floor muscles, and then we’re really addressing lifestyle and diet. But it was like, Gosh, we’re missing something. So just to give you that context, I went down to Sedona with my mom. She brought her dog. And I brought my dog and. Just to give you that context, also, this seems like a little bit of a wandering story. The first couple of days in the course, I kind of thought to myself, I don’t know, I’m not feeling this because a lot of what we were doing is intuitive listening of the body where we simply place hands on the abdomen and energetically start to tune in to What are we feeling? What what is drawing us to look a little bit further, so to speak? And the touch is really light. If anybody’s ever had cranial sacral work. It’s very similar to that. And gosh, in my practice that’s just not how I was used to treating right. I’d watch somebody move. I would do joint mobilizations, really assess how things are moving physically, right? There was never any sort of energetic component to any of the work that I did. So I’ll tell you what, by the end of the course, I was like, I don’t I don’t think this is for me. I don’t I don’t know what I’m feeling. I don’t know what I’m doing. Is this even real? Certainly crossed my mind in the very last day when I got to. The class. I think it started at 8 a.m. I’d eaten around 7 a.m. probably at 10 a.m. I got the most intense pain in my stomach. Intense, intense pain. And. I had the clinical and or that teacher come and listen to my stomach and she said, you know, this isn’t your pain. You picked this pain up somewhere. This is energetic pain. It’s not yours. And as quickly as it came on, it went away and it was significant pain. So I knew it was it and it was in my stomach. So I knew it really probably wasn’t from something that I had eaten because I felt like my stomach had emptied. And when my mom came to pick me up from the course, at the end of the day, she said, I don’t want you to be nervous and be angry with me. But your dog got up on the counter while I was showering and ate a chocolate bar and I had to take her to the vet to get her stomach pumped. And the times coincided with my stomach pain. Exactly. Which for many people they may not buy into that. But it was really something that opened my eyes that there may be more to them in terms of energy. Right. And how we we treat the body, maybe intuitively, I knew that something was going on. Maybe I was just simply nervous. But it was pretty remarkable that I had an experience in that course where I had really intense digestive symptoms that went away suddenly. So if nothing else, it proved to me how much the nervous system can play into things. So as I’ve implemented this into my practice, more and more, there are people that are not as in-tune or and really don’t adhere to a lot of energetic practices. And that’s totally fine because we can work with them and work with the mechanics, because I can physically feel the mobility of an organ and see how it’s moving, and then they’ll have a physical experience and an improvement after treatment. I also have a lot of people that do really buy into the energetic practices and those sorts of modalities, and they’ve had profound effects in implementing some of this.
Dr. Ann-Marie Barter: Awesome. Thanks for sharing that story. Is there anything that we forgot to touch on on visceral manipulation that might be important to add?
Dr. Amy Osborne: You know, I think that one of the biggest things is that we have to think about our nervous system. And I know I kind of hinted at that and then briefly touched on that. But it really is true that the nervous system is the ruler of all things, whether it’s from a perception standpoint or whether it’s truly from that autonomic vagal tone in how our gut responds to things. So if there’s anything that people can really be doing to promote mobility, motility, appropriate movement of their organs, it truly is lifestyle practices. So whether that’s meditation breathwork, I know cold exposure therapy can be really, really helpful for people, but I think that the most important thing is to eat in a parasympathetic state, because if you do have any sort of motility issues where maybe your stomach is not regulated or your large intestine or your small intestine or whatever it may be, if we go into a meal in a sympathetic state, your body is not primed and prepped to really digest that that meal and then utilize the nutrients appropriately. Right. So eating on the go is really I think and I’m guilty of that. Right? I think a lot of people probably are going to eat something in my car or I’m going to I’ll chomp something down in between patients all the time. And even I know that some of those things are unavoidable. Right. But I think that the most important thing is that before we eat, we take at least 90 seconds to really ground, get present, take some really deep diaphragmatic breaths simply by stimulating the diaphragm. It’s going to change the abdominal pressure. It’s going to not only change that abdominal pressure, bring blood flow to the area, but it’s going to signal to our nervous system that, okay, we’re safe right now. We can receive the food. We can digest that food, and that’s that.
Dr. Ann-Marie Barter: Well said. Well said. Where can people find you if they want to get in touch with you?
Dr. Amy Osborne: Yeah. My practice is opto physical therapy. That’s APTO, and I’m in the highlands neighborhood of Denver.
Dr. Ann-Marie Barter: Awesome. Well, thank you so much for coming on the show today and explaining this role manipulation, which I think is so important and sharing all of your knowledge. Thank you so much for being here.
Dr. Amy Osborne: Yeah, thank you for having me.
Outro: Thank you for listening to the Gut Health Reset Podcast. Please make sure you subscribe. Leave a rating and a review. The more people can hear about the podcast and hey, take a screenshot of this episode and tag Dr. Anne Marie on Instagram or Facebook at Dr. Ann-Marie Barter. And for more resources, just visit Dr. Ann-Marie Barter.com.